Endoscopic ear surgery (EES) is an emerging practice in the management of otologic disease. The field of otology is a mature specialty which allows for management of advanced ear disease, primarily relying on direct line-of-sight visualization with a binocular operating microscope. In order to access disease beyond this field of view, healthy bone must be drilled away and soft tissue must be divided and retracted, with secondary tissue trauma.

Advances in endoscopic optics, instrumentation, ergonomics, and surgical technique have enabled surgeons significant advantages in visualization, access, and removal of disease with a substantial reduction in removal or disruption of healthy tissue. In many cases, the traditional postauricular approach can be avoided, with surgery being performed entirely through the ear canal.

This emerging specialty is not yet practiced widely in the United States, however interest is strong and rapidly growing. Our course offers a broad overview of the state of endoscopic ear surgery. Didactic sessions will cover history of EES, extensive discussion of surgical techniques with multimedia content, and strategies for incorporating EES into practice for beginners through advanced practitioners. Hands on sessions in the temporal bone laboratory led by our course faculty will allow participants to experience and practice endoscopic techniques developed at our institution and by surgeons from around the world.

There is a growing trend in otolaryngology towards greater sub-specialization, while concurrently there is an increasing shortage of otolaryngologists in the United States. This course will seek to bring practicing otolaryngologists up to date with the latest techniques in otologic surgery, including chronic ear disease, otosclerosis, vestibular disorders, and endoscopic ear techniques. MEEI faculty will provide lectures and dissection demonstrations.

The two first two days will focus on traditional microscopic otologic approaches and the final full day will be dedicated to endoscopic ear surgery.

This is a dedicated endoscopic ear surgery course for the first two days followed by a basic and advanced temporal bone course with whole skull dissection.

Participants will be able to use the latest surgical technology in the lab - including rigid endoscopes, drills from several manufacturers, middle ear implants and prostheses, KTP and CO2 lasers, and cochlear implant electrodes.

General otolaryngologists, pediatric otolaryngologists, otologists, and neurotologists are welcome.

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Pediatric and adult cochlear implants - an overview of clinical indications for cochlear implants, the multidisciplinary team based at the Massachusetts Eye and Ear Infirmary (MEEI), minimally invasive surgery, titanium screw fixation techniques to avoid tie down holes (especially when the skull is thin in patients 12 months of age or less), basic overview of CI surgery, and what to expect following surgery.

Meningitis and cochlear implants -although a rare occurrence following CI surgery, it is important that all adult patients receive the correct PNEUMOCOCCAL vaccines and this includes both the Pneumovax and Prevnar 13.

Senator Jamie Eldridge teamed with Dr. Daniel Lee of MEEI and submitted S421 (formerly S469 and H3855), which would require health insurance plans to cover cochlear implant operations and post treatment services for children. Insurance is a major access factor to the CI technology. Please contact your legislator in support of this important piece of legislation to help deaf infants and children of the Commonwealth receive cochlear implant services.

superior semicircular canal dehiscence / superior canal dehiscence syndrome - known as Minor syndrome, superior canal dehiscence is a middle fossa skull base defect involving one of the vestibular (balance) organs. Specifically, a tiny hole in the superior (also known as anterior semicircular canal) in one or both ears can cause hearing loss AND/OR imbalance / dizziness, fullness of the involved ear and autophony (echo during self-vocalization). Superior semicircular canal dehiscence (SSCD) or superior canal dehiscence syndrome (SCDS) can result in many symptoms that resemble more common disorders of hearing loss and imbalance like otosclerosis, Eustachian tube dysfunction, patulous Eustachian tube, Menieres disease or BPPV.

Patients who need surgery can undergo repair of SCDS using either a transmastoid or middle fossa craniotomy surgery. The choice of the approach is based on the location of the dehiscence and presence of associated skull base defects.